Enhancing Depth of Reflection of Family Medicine Residents: Results of an Intervention

Abstract

The ability to reflect in professional practice is the cornerstone of self-directed learning. Reflective practice in medicine is an important teaching-learning modality for improving decision-making and clinical reasoning. It is a strategy for self-regulation of clinical and academic performance. This study was undertaken with the aim of improving the reflective ability skills of family medicine residents through the introduction of reflective practice at Aga Khan University. This was a case study using a pre-post design. A questionnaire was administered to assess the baseline level of reflection in family medicine residents, followed by a workshop on reflective practice to orient residents about the process and levels of reflection. Residents were asked to document reflective logs on a blog, feedback was provided. Post-intervention data were collected by re-administration of the questionnaire to assess the change in the reflective level. Pre-post questionnaire data were analysed for comparisons using the Wilcoxin Sign Rank test on SPSS version 19. Out of 15 eligible residents, a total of 13 residents were available during the study period. In a pre-intervention questionnaire, reflective levels across the domains indicated that residents used reflection 50% of the time which increased post-intervention to more than 80% of the time. The degree of pre-post difference was lowest in the ‘Habitual Action Domain’ and largest in the domains of ‘Reflection’ and ‘Critical Reflection’ (4.1-4.8 and 3.8-4.5). Reflective practice is an effective strategy to develop residents as reflective thinkers by increasing their depth of reflection. Facilitation of their reflection through feedback enhances their ability to reflect.

Keywords

• clinical reasoning
• reflection
• reflective practice
• critical thinking
• intervention